人工流产术前应用米索前列醇疗效观察

目的:探讨早孕人工流产吸宫术前应用米索前列醇的效果.方法:将门诊行人工流产的早孕孕妇分为实验组及对照组.实验组180例,吸宫术前2h阴道内置米索前列醇片0.2mg.对照组180例,术前不用药.分别观察两组宫颈软化扩张程度及手术时间、出血量.结果:实验组宫颈软化扩张总有效率72.8%,对照组为23.9%.实验组与对照组相比有显著差异(P<0.01),手术时间明显缩短、出血量明显减少(P<0.01).结论:米索前列醇用于早孕吸宫术前能明显减轻患者疼痛及出血量,值得临床应用.     

米索前列醇不同用药途径对人工流产术的影响

目的探讨米索前列醇不同用药途径对人工流产术的影响。方法将自愿要求人工流产、孕周在5~11周、月经周期正常、无服药禁忌症的早孕妇女300例,分成3组,A组100例,阴道内置米索前列醇;B组100例,术前口服米索前列醇;C组100例,术前不用任何药物,按常规人流术前准备。观察米索前列醇在人工流产术中的作用。结果A组宫颈扩张软化总有效率100%,其中宫颈充分软化率达99%;B组总有效率达99%,其中宫颈充分软化率达96%;给药组与常规人工流产组相比差异有显著性(P<0.05)。结论米索前列醇400μg术前1h阴道应用为一种简便、安全、有效的宫颈软化法。     

米索前列醇在人工流产中的运用

目的:观察将米索前列醇用于人工流产术时宫颈软化、扩宫镇痛和减少出血的效果。方法:将要求人工流产的120例患者随机分成两组,米索前列醇组60例,于术前1-2h阴道冲洗,干棉球擦干阴道分泌物,置2片(400μg)米索前列醇于阴道后穹窿。对照组60例,于术前1-2h以同样方法置甲硝唑0.2g。结果:人工流产术中,米索前列醇组人工流产综合征发生率仅为11.7%,对照组为36.7%,米索前列醇组明显低于对照组。米索前列醇组无痛11.7%,轻痛48.3%,中痛33.3%,重痛6.7%。对照组无痛0%,轻痛5%,中痛43.3%,重痛48.4%。两组比较差异有显著性(P<0.01)。米索前列醇组宫颈充分软化扩张81.7%,软化扩张13.3%,软化扩张不良5.0%。对照组宫颈充分软化扩张8.3%,软化扩张20.0%,软化扩张不良71.7%。两组比较差异有显著性(P<0.01)。米索前列醇组术中出血量少于30ml者占83.4%,30～60ml者占13.3%,大于60ml者占3.3%。对照组术中出血量少于30ml者占30.0%,30～60ml者占36.7%,大于60ml者占33.3%。两组比较差异有显著性(P<0.01)。结论:人工流产术前1-2h置2片(400μg)米索前列醇于阴道后穹窿,能有效的扩宫、镇痛、软化宫颈,减少阴道出血和人工流产综合征,值得临床推广应用。     

米索前列醇在宫腔镜检查术中的应用

目的 探讨米索前列醇在宫腔镜检查术中对宫颈软化及镇痛的效果。方法 198例宫腔镜检查患者随机分为两组,99例(用药组)术前3～18小时阴道后穹窿放置米索前列醇400ug,99例(对照组)未放置任何药物。观察术中宫颈软化、扩宫率、扩张宫颈所需时间、疼痛情况及出血情况。结果 用药组较对照组扩宫率下降,扩张宫颈更轻松,扩张宫颈所需时间明显缩短,差异有极显著性意义(P<0.01);感觉疼痛的机率减少,疼痛程度明显减轻,差异有显著性意义(p<0.05);人流综合征(PAAS)发生率仅为9.1％,对照组为52.5％差异有权显著性(P<0.01);术中出血少,差异有极显著性意义(P<0.01)。结论 术前阴道后穹窿放置米索前列醇400ug为方便、有效、安全的软化宫颈的理想方法,值得临床推广应用。     

米索前列醇在宫腔镜检查前的宫颈预处理中临床效果观察

目的:对米索前列醇在宫腔镜检查前的宫颈预处理的临床效果进行观察。方法:抽取2013年2月-2014年2月在本院行宫腔镜检查的186例患者作为观察对象,将其随机分为米索前列醇组(n=106)和对照组(n=80),米索前列醇组检查前2~12h阴道后穹窿置米索前列醇片400μg,对照组检查前6~12h宫颈放置导尿管。观察并比较两组患者人流综合征(PAAS)发生率、疼痛情况及宫颈软化、扩张情况。结果:米索前列醇组PAAS发生率1.9%明显低于对照组31.3%,米索前列醇组感觉疼痛者比例87.7%明显低于对照组100.0%,米索前列醇组扩宫率为29.2%明显低于对照组扩宫率81.3%,米索前列醇组扩张宫颈所需时间平均(5.18±2.9)min短于对照组(11.8±8.2)min,组间比较差异显著,具有统计学意义(P均<0.05)。结论:宫腔镜检查前2~12h阴道后穹窿一次性置入米索前列醇400μg可有效软化宫颈,减轻患者的疼痛程度,值得临床推广应用。     

米索前列醇在宫腔镜检查时应用效果的观察

观察米索前列醇在宫腔镜检查时软化宫颈的临床效果,选择2005年1月-2006年12月在我院门诊行宫腔镜检查的病人80例,随机分为两组,实验组40例行宫腔镜检查前3h阴道放置米索前列醇200μg;对照组40例宫腔镜检查前3h口服米索前列醇400μg,观察宫颈软化情况、并发症发生情况。结果两组患者用药后宫颈充分软化、软化和软化不良的发生率差异无统计学意义(P>0.05);认为米索前列醇200μg检查前阴道内放置,或400μg检查前口服,均可有效扩张宫颈,而200μg阴道内放置是更为安全有效的扩张宫颈的方法。     

宫腔镜手术前米索前列醇与海藻棒扩张宫颈的比较

目的:比较米索前列醇和宫颈插海藻棒在宫腔镜电切手术中扩张宫颈的作用。方法:将宫腔镜手术的60例患者随机分为2组,米索前列醇组30例,手术前3 h阴道置米索前列醇400μg,海藻棒组30例,手术前12 h经阴道宫颈插海藻棒。结果:米索前列醇组用7号以上扩张棒扩张宫颈有28例,占93.3%,海藻棒组用7号以上扩张棒扩张宫颈有3例,占10%,米索前列醇组比海藻棒组宫颈内口扩张程度好。宫腔镜手术米索前列醇组人工流产综合征(PAAS)发生率明显低于海藻棒组(P<0.05)。宫腔镜手术中米索前列醇组比海藻棒组VAS评分有显著性差异(P<0.05)。结论:宫腔镜手术前3 h阴道置米索前列醇400μg为方便、有效的软化宫颈的方法,可缓解疼痛,减少操作,减少并发症。     

米索前列醇用于人工流产中的临床观察

目的 观察米索前列醇对人工流产术的影响。方法 将自愿要求人工流产、孕周在6～11周、月经周期正常,无用药禁忌症的早孕妇200例,随机分成观察组100例,对照组100例,观察组阴道内置米索前列醇;对照组不用任何药物,按常规人流术前准确。观察米索前列醇在人工流产中的作。结果 观察组宫颈扩张、软化总有效率100%,其中充分扩张率达99%。与对照组相比差异显著性（P〈0.05）。结论 米索前列醇术前1小时放置阴道为一种简便、安全、有效的宫颈软化法。     

米索前列醇在人工流产术中的扩宫和镇痛效果

目的　观察米索前列醇用于人工流产术时宫颈软化、扩宫镇痛和减少出血的效果。方法　将要求人工流产的 1 1 8例患者随机分成两组 ,米索前列醇组 59例 ,于术前 3h阴道抹洗 ,干棉球抹干阴道分泌物 ,置 2片(40 0 μg)米索前列醇于阴道后穹窿。对照组 59例 ,于术前 3h以同样方法置灭滴灵 2片于阴道后穹窿。 结果　人工流产术中 ,米索前列醇组人工流产综合征发生率仅为 1 0 2 % ,对照组为 32 3 % ,米索前列醇组明显低于对照组。米索前列醇组无痛 1 0 2 % ,轻痛 50 8% ,中痛 2 8 8% ,重痛 1 0 2 %。对照组无痛 0 % ,轻痛 8 5 % ,中痛 42 4% ,重痛49 1 %。两组比较差异有显著性 (P <0 0 1 )。米索前列醇组宫颈充分软化扩张 81 3 % ,软化扩张 1 3 5 % ,软化扩张不良 5 2 %。对照组宫颈充分软化扩张 1 0 2 % ,软化扩张 2 0 3 % ,软化扩张不良 69 5 %。两组比较差异有显著性(P <0 0 1 )。米索前列醇组术中出血量少于 30ml者占 83 % ,30～ 60ml者占 1 1 8% ,大于 60ml者占 5 2 %。对照组术中出血量少于 30ml者占 33 9% ,30～ 60ml者占 42 4% ,大于 60ml者占 2 3 7%。两组比较差异有显著性 (P<0 0 1 )。结论　人工流产术前 3h置 2片 (40 0 μg)米索前列醇于阴道后穹窿 ,能有效的扩宫、镇痛、软化宫颈     

米索前列醇在宫腔镜技术的应用观察

目的：观察米索前列醇在官腔镜技术中软化宫颈及镇痛效果。方法：选择行官腔镜检查并予以治疗的患者共68例,随机分为两组,米索前列醇组36例于术前3h置米索前列醇0．4mg,对照组32例于术前3h放置灭滴灵0．4g,两组均采用Ф9mm诊断治疗宫腔镜,宫颈扩张至9．5mm,先行官腔镜检查后,经治疗镜操作孔置器械直视下治疗宫内病变。结果：米索前列醇组人工流产综合症发生率仅11．1％,对照组56．4％,两组有明显差异,米索前列醇组明显低于对照组。VAS评分米索前列醇组无痛者11．1％,轻痛者22．2％,中痛55．5％,剧痛者11．1％,对照组无痛者0,轻痛者9．37％,中痛40．6％,剧痛50．0％,两组有显著差异,米索前列醇组疼痛明显轻于对照组。米索前列醇组宫颈充分软化66．7％,软化25．0％,软化不良8．3％,总软化率91．7％。对照组宫颈充分软化0％,软化12．5％,软化不良87．5％,总软化率12．5％,经比较两组有极显著差异。结论：官腔镜技术前3h用米索前列醇400pg阴道给药为简便、有效的软化宫颈理想方法,减少了手术操作,减轻了患者的痛苦,值得临床推广应用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.